PMID- 16216764
OWN - NLM
STAT- MEDLINE
DCOM- 20060214
LR  - 20220408
IS  - 1099-5129 (Print)
IS  - 1099-5129 (Linking)
VI  - 7
IP  - 6
DP  - 2005 Nov
TI  - Evaluation of left bundle branch block as a reversible cause of non-ischaemic 
      dilated cardiomyopathy with severe heart failure. A new concept of left 
      ventricular dyssynchrony-induced cardiomyopathy.
PG  - 604-10
AB  - OBJECTIVES: We sought to determine if amelioration of left bundle branch block 
      (LBBB)-induced contraction disturbances achieved by left ventricular (LV)-based 
      pacing could result in sustained reversal of severe LV dysfunction in certain 
      patients with chronic heart failure due to non-ischaemic cardiomyopathy. 
      BACKGROUND: It has been shown that LBBB induces asynchronous contraction of LV. 
      However, whether such a functional contraction disturbance, if present for an 
      extended period of time, could account for a dilated cardiomyopathy remains 
      unknown. METHODS: The study population comprised 29 patients with dilated 
      cardiomyopathy, sinus rhythm, LBBB and severe heart failure (14 patients in New 
      York Heart Association (NYHA) class III and 15 in class IV). Patients were 
      followed prospectively after resynchronization therapy. LV function was 
      considered to be normalized when ejection fraction (EF) was >50% at 1 year. 
      RESULTS: Five among the 29 patients (17%: group 1) demonstrated both complete 
      normalization of LV function following resynchronization therapy (EF: from 19+/-6 
      to 55+/-3%, P = 0.001) and clinical improvement (mean NYHA class: 3.4+/-0.5 to 
      1.8+/-0.4, P = 0.02; 6-min walk distance: 300+/-136 to 444+/-75 m, P = 0.12; peak 
      VO2: 11.9+/-4 to 15.8+/-2 ml/min/kg, p = 0.03). Among the remaining 24 patients 
      (83%: group 2) EF improved but did not normalize (from 21+/-8 to 23+/-11%, ns). 
      Baseline clinical features could not predict which patients would exhibit the 
      reversal of LV dysfunction. CONCLUSIONS: Normalization of LV function 1 year 
      after resynchronization therapy in a small but important number of patients 
      suggests that long-standing LBBB may be a newly identified reversible cause of 
      cardiomyopathy.
FAU - Blanc, Jean-Jacques
AU  - Blanc JJ
AD  - Department of Cardiology, Hopital de la Cavale Blanche, Brest University 
      Hospital, Boulevard Tanguy Prigent, 29609 Brest Cedex, France. 
      Jean-Jacques.Blanc@univ-brest.fr
FAU - Fatemi, Marjaneh
AU  - Fatemi M
FAU - Bertault, Valerie
AU  - Bertault V
FAU - Baraket, Feriel
AU  - Baraket F
FAU - Etienne, Yves
AU  - Etienne Y
LA  - eng
PT  - Journal Article
DEP - 20050913
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Aged
MH  - Bundle-Branch Block/*complications/physiopathology/therapy
MH  - Cardiac Pacing, Artificial
MH  - Cardiomyopathy, Dilated/*etiology
MH  - Female
MH  - Heart Failure/*etiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - *Pacemaker, Artificial
MH  - Ventricular Dysfunction, Left/*complications/physiopathology
EDAT- 2005/10/12 09:00
MHDA- 2006/02/16 09:00
CRDT- 2005/10/12 09:00
PHST- 2004/11/24 00:00 [received]
PHST- 2005/06/03 00:00 [revised]
PHST- 2005/06/30 00:00 [accepted]
PHST- 2005/10/12 09:00 [pubmed]
PHST- 2006/02/16 09:00 [medline]
PHST- 2005/10/12 09:00 [entrez]
AID - S1099-5129(05)00321-1 [pii]
AID - 10.1016/j.eupc.2005.06.005 [doi]
PST - ppublish
SO  - Europace. 2005 Nov;7(6):604-10. doi: 10.1016/j.eupc.2005.06.005. Epub 2005 Sep 
      13.